Dr. Anil Kumar (second from right) is the medical officer-in-charge in Chhas and a trained NSV surgeon.
In the steel city of Bokaro in Jharkhand, India, efforts to involve men in family planning primarily focus on a procedure called no-scalpel vasectomy (NSV). In fact, the entire country holds an “NSV Fortnight” every year from November 21 to December 4 to promote male engagement in family planning. However, in Bokaro, data from the Health Management Information System (HMIS) revealed that only three NSVs were performed there between April 2021 and December 2021.
Fortunately, the situation improved after the city received support from The Challenge Initiative (TCI), which provided guidance and training on male engagement strategies to health workers in Bokaro. TCI aimed to increase male participation in family planning, promote gender equity and encourage the use of methods like NSV. As a result of TCI’s support, the number of NSV procedures increased to 21 from April 2022 to December 2022.
These improved results were due to a number of activities in the area surrounding the secondary hospital and community health center (CHC) in Bokaro, known as Chhas. As part of a demand-generation effort, TCI supported Accredited Social Health Activists (ASHAs), who observed male gatherings called ‘Chauraha,’ where men are encouraged to actively participate in family planning as individuals and partners. While more than 20 ASHAs showed interest after their observations, six or seven of them now include male engagement in their regular work.
The ASHA’s efforts led to increased awareness and demand for NSV in the community and the number of people coming to the clinic specifically seeking a NSV began to rise. However, the CHC did not have the necessary equipment or operating rooms for NSV procedures, so potential clients were referred to a tertiary hospital. But if the tertiary facility wasn’t performing NSVs on that day, clients would return to the CHC, resulting in missed opportunities.
Dr. Anil Kumar, the medical officer-in-charge in Chhas, is a trained NSV surgeon. He recognized this growing interest in NSV among men, but was frustrated with the referral process. TCI worked with Dr. Kumar to review the records of NSV clients at the CHC for the past two months and this data sparked his interest in finding solutions to prevent any missed opportunities.
After TCI showed Dr. Kumar the budget provisions under the program implementation plan (PIP) for his CHC, he realized that he could procure the necessary equipment and convert a storeroom into an operating room within his budget limits. Within a few days, he began performing NSV procedures at the Chhas CHC.
And the 2022 NSV Fortnight also provided an opportunity to promote NSVs as ASHAs in Chhas actively spread the word about the event to generate increased demand. During the 2022 event, all interested individuals seeking NSV services received them at the Chhas CHC. The results were remarkable, as TCI-supported cities performed 200% more NSVs compared to the previous year’s NSV Fortnight.
Shabbir Anwar, the district data manager of Bokaro, acknowledged the support they received from TCI, which he said played a crucial role in improving their performance.
